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Flashcards in Internal Medicine Deck (24):

Anticholinergic meds used to treat urge incontinence can cause what ocular side effect? In what patients taking what type of medications do you not want to combine them with?

- acute angle glaucoma
- patients taking cholinesterase inhibitors for dementia bc the combo accelerates cognitive decline


What are 2 definitive tests to do if you are thinking of diagnosing someone with BPH?

1. urinalysis - look for hematuria
2. DRE - palpate the prostate


What are the categories of erectile dysfunction?

1. Organic - neurogenic, vascular, hormonal
2. Medications
3. Psychogenic


Cessation of smoking can make what disease worse?

Ulcerative colitis


What is the 5A framework for smoking cessation?

1. Ask about tobacco use
2. Advise to quit through clear messages
3. Assess willingness to quit
4. Assist to quit
5. Arrange follow-up and support


What are the 3 criteria that should be met to perform low dose CT scan screening for lung cancer?

1. Men or women 55-79
2. current smoker or have quit within the past 15 years
3. >/= 30 pack year smoking history


A patient presents with sudden onset of painless double vision. What should I suspect?

Cranial nerve involvement


If you knock out the 3rd cranial nerve, how is the eye deviated?

Down and out, ptotic eyelid, dilated pupil


What happens if you knock out the 6th cranial nerve?

You can't move the eye laterally


What happens if you knock out the 4th cranial nerve?

eye is deviated upward and the head is tilted toward the uninvolved side


What organism causes eye infection in a contact lens wearer who washes with tap water?

Acanthamoeba keratoconjunctivitis
- Fusarium can also affect contact lens wearers


An injection drug user who dilutes his heroin in contaminated lemon juice is at increased risk for what infection?

Candida endophthalmitis


Why is distinguishing between anterior uveitis and viral keratitis so important in terms of treatment?

AU is treated with topical steroids; topical steroids make VK worse


What does DUMBELS in organophosphate poisoning stand for?

Defecation, urination, miosis, bronchospasm/bradycardia, emesis, lacrimation, salivation + fasciculations and weakness


What symptoms do you see with tricyclic antidepressant overdose?

Anticholinergic symptoms (flushing, hypotension, dilated pupils) and a prolonged QRS
- treat with IV sodium bicarb


Dilated pupils and yawning signify what?

Opiate withdrawal


Fatal gout drug interactions. What should you avoid if the patient is on...
1. colchicine?
2. allopurinol?

1. clarithromycin and erythromycin
2. azathioprine


What is sensitivity? Specificity?

Sensitivity - patients with disease who test positive
Specificity - patients without disease who test negative


What are some teratogenic meds in pregnancy commonly tested on exams?

ciprofloxacin, warfarin, nitroprusside, doxycycline, and valproic acid


What 2 delirium scenarios should a patient not be given haldol?

1. known long QT
2. parkinson's dz


What are some live vaccines that pregnant women cannot get?

influenza (nasal form), varicella, MMR (mumps, measles, rubella; all of them!), chicken pox, rotavirus, oral polio, typhoid, yellow fever, and rabies.


What is PPV? NPV?

PPV - probability that patients with a positive test have the disease
NPV - probability that patients with a negative test don't have the disease


What are some immunosuppressive medications that are safe to use in pregnancy?

cyclosporine, tacrolimus, and prednisone


What med leads to the most common warfarin interaction leading to hospitalization in the U.S.

The combination of warfarin and TMP/SMX can be a very deadly one.